The U.S. population is becoming more culturally diverse each year, at a faster rate than previously forecasted by census data. Ahead of the nation’s 2020 census, it was estimated that almost four in ten Americans identified with a non-white ethnic group or race. Between 2000 and 2019, the white population decreased by 10%.1 In the mental health counseling profession, cultural diversity plays a significant role. Whether it’s multicultural representation within the counseling industry or the increased attention on multicultural training to serve an increasingly diverse population more effectively, cultural diversity in counseling is a hot topic.
Multicultural counseling professionals with the right training and expertise are in high demand. Keep reading to learn about cultural diversity in counseling—how different ethnicities are represented in the field, key multicultural considerations in counseling policy and practice, and steps that are being taken to encourage cultural competence.
Cultural diversity in counseling: Representation
Despite increasing diversity in the U.S. and the higher rate at which people of color (POC) experience barriers to care and adverse mental health outcomes, mental health professionals are mostly white.2 According to the American Psychological Association in 2015, just 15% of psychologists in the U.S. were POC.3 By 2019, this number hadn’t improved significantly. The Bureau of Labor Statistics reported that in the U.S., almost 70% of social workers and 76% of mental health counselors were white.4
This lack of representation makes the need for multicultural training in the counseling profession even more urgent.
Why multicultural counseling is important
Cultural identity affects how people view mental health, illness, and the world. This has far-reaching implications for mental health counselors and the counseling profession in general, whether it’s to understand how people of a certain culture seek treatment, how they view the client/therapist counseling relationship, or how they internalize and deal with discrimination issues. Counselors must be able to engage clients from diverse cultures in an equitable and sustainable manner.5
The following are important considerations at the intersection of cultural diversity and mental health counseling.
Perception of Health and Illness
How a person perceives health and illness varies across cultures. This can affect whether people are inspired to seek treatment, the amount of support they receive from their family and community, and where they go to seek help. They may look to a mental health counselor, primary care provider, member of the clergy, or traditional healer. Their cultural perspectives can also affect the path they take to obtain health services and the success of the outcome.5
How People Seek Treatment
It has been found in High-Income Countries (HICs), such as the U.S., Canada, and Australia, that individuals belonging to other cultures seek help later when facing mental distress, even when the situation is more acute. This may be related to a feeling of shame, as confirmed by research conducted with refugees and migrants in HICs and populations in lower-income countries in Asia. There may be a reluctance to share personal information with strangers or a desire to protect individual dignity and family reputation. For this reason, talk therapy may be less successful than other counseling modalities. 5
The Concept of Stigma
Stigma can play a vital role in a person’s reluctance to seek treatment, and social stigma related to mental illness can be greater in certain cultural groups. It may cause people to hide symptoms and not seek out a counselor until their issues are more severe. Especially in regions where there is no governmental assistance, lack of family support due to stigma may lead to mental health neglect.5
Willingness to seek treatment is also linked to the history of a person’s cultural group. For example, in HICs that have a colonial past, indigenous people are predisposed to mental health issues that can be linked to a history of oppression, dispossession, and intergenerational trauma. Due to histories of persecution and racism, people in Latino and African American communities may also distrust clinicians.5
Racism and Discrimination
In addition to negative beliefs toward certain cultures, racism may lead to mental health treatment inequity for some cultural groups. Experiencing racism and a hostile environment can cause an individual to become socially alienated and fearful of public spaces, reducing access to counseling services. This can adversely affect mental health. In addition, a lack of understanding of cultural differences can cause healthcare practitioners to stereotype or misinterpret situations, which may lead to inappropriate or inadequate treatment.5
Coping Mechanisms and Resilience
People of different cultures have unique ways to cope with stressful situations in their lives. Understanding how diverse cultures cope with hardships can help to promote mental health and prevent illness. Resilience—the ability to persevere through adversity—is dependent upon a person’s characteristics and traits, and is part of the individual’s cultural values, identity, and collective history. Cultures that place a strong emphasis on family and community can either be protective or a risk when it comes to mental health issues, depending on whether the collective is supportive or enforces stigma.5
The Therapeutic Relationship and Cultural Impacts
The counseling relationship between client and therapist is essential in mental health treatment. Ideally, both would be from the same culture, but this isn’t always possible. In addition to cultural differences, there may be language barriers, and having a common language is essential for cultural understanding. While many HICs will ensure that interpreters are available, a lack of interpreters continues to be a problem globally.5
Society as Patient
Not all mental health problems are within the individual. Sometimes a lack of well-being is caused by a person’s external environment. This is especially true for refugees, migrants, and indigenous people in HICs who may be marginalized and discriminated against. It has been suggested that counselors and other mental health professionals who work with people from diverse cultures may become social activists to challenge situations in society that affect their clients. This involves the concept of globalization, where increased global interconnectedness may cause displaced individuals to become disconnected from their usual social networks. As traditional healing systems are replaced by Western modalities that may be inadequately resourced and inappropriate, there is a need to strengthen individuals and their communities for more positive mental health outcomes.5
Improving cultural diversity in counseling
Within the past decade, professionals in the mental health field have acknowledged the need to incorporate cultural diversity in counseling to provide the best possible care for people with varied racial and ethnic backgrounds.
“Multicultural/diversity competence”—also phrased as “cultural competence” or “multicultural counseling competence”—refers to a therapist’s awareness of cultural and diversity issues, that person’s understanding and knowledge of themselves and others, and how this is effectively applied in counseling practice. In 2014, The American Counseling Association (ACA) released its ACA Code of Ethics, which directs counselors to recognize and respect clients’ cultural differences when using assessment techniques and in supervisory roles. Counselor educators are advised to include multicultural and diversity training in their workshops and courses and to recruit a diverse student body.6
The Substance Abuse and Mental Health Services Administration (SAMHSA) published the Improving Cultural Competence Quick Guide for Clinicians as part of its Treatment Improvement Protocol (TIP) series. This guide defines cultural competence, explains why it’s important and provides guidelines for working with culturally diverse individuals.7
A 2019 ACA article on multicultural encounters in mental health counseling highlights the need for counseling professionals to expand their awareness and knowledge of multiculturalism and enhance their skills in order to serve an increasingly diverse population effectively.8
Become a leader in multicultural counseling
With an online Master of Science in Clinical Mental Health Counseling (CMHC) from Marquette University, you can pursue a fulfilling career as a counselor, serving culturally diverse clients. In as few as three years, you’ll be highly qualified to work in a wide range of settings, from hospitals and community health centers to prisons, residential mental health facilities or private practice. The CMHC program combines rigorous coursework taught by seasoned professionals with a practicum and internship in the field.
Take a deep dive into topics such as the foundations of clinical mental health counseling, multicultural training, professional ethics and legal issues, psychopathology and diagnosis, research methods, assessment, family and group counseling, and addictions.
To learn how the Marquette University online MS in Clinical Mental Health Counseling can help you begin or advance your career in counseling, contact an Admissions Advisor today.
- Retrieved on December 28, 2022, from brookings.edu/research/new-census-data-shows-the-nation-is-diversifying-even-faster-than-predicted/
- Retrieved on December 28, 2022, from nami.org/Blogs/NAMI-Blog/March-2022/Addressing-the-Lack-of-Diversity-in-the-Mental-Health-Field
- Retrieved on December 28, 2022, from apa.org/monitor/2018/02/datapoint
- Retrieved on December 28, 2022, from bls.gov/cps/cpsaat11.htm
- Retrieved on December 28, 2022, from frontiersin.org/articles/10.3389/fpubh.2018.00179/full
- Retrieved on December 28, 2022, from counseling.org/resources/aca-code-of-ethics.pdf
- Retrieved on December 28, 2022, from store.samhsa.gov/sites/default/files/d7/priv/sma16-4931.pdf
- Retrieved on December 28, 2022, from ct.counseling.org/2019/11/multicultural-encounters/